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Metagenomic Next-Generation Sequencing of Cerebrospinal Fluid for the Detection of Central Nervous System Pathogens
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Comparison of postsurgical and community acquired bacterial meningitis--analysis of 372 cases within a nationwide

A Streharova1, J Benca, K Holeckova

  • 1University Hospital Trnava, Slovakia.

Neuro Endocrinology Letters
|November 22, 2007
PubMed

Insights

This study compared bacterial meningitis after surgery (PM) versus in the community (CBM), finding different causes and risk factors but similar patient outcomes. Understanding these differences is key for effective bacterial meningitis treatment.

Area of Science:

  • Infectious Diseases
  • Microbiology
  • Clinical Medicine

Background:

  • Bacterial meningitis presents distinct challenges depending on its acquisition source: post-surgical (PM) or community-acquired (CBM).
  • Understanding the etiological and risk factor variations between PM and CBM is crucial for optimizing patient management and outcomes.

Purpose of the Study:

  • To compare the etiology, risk factors, and outcomes of bacterial meningitis in patients who acquired it after surgery versus in the community.
  • To identify specific pathogens and predisposing conditions associated with each type of bacterial meningitis.

Main Methods:

  • A retrospective analysis of 372 bacterial meningitis cases over 17 years from 10 Slovak hospitals.
  • Data collected included etiology, risk factors (e.g., neurosurgery, cancer, diabetes, VLBW, sepsis, alcohol abuse), and patient outcomes (mortality, survival with sequelae, therapy failure).
  • Statistical comparison of etiological agents and risk factors between PM and CBM groups.

Main Results:

  • Significant differences in causative pathogens were observed: Coagulase-negative staphylococci, Enterobacteriaceae, and Acinetobacter baumannii were more common in PM, while Streptococcus pneumoniae, Neisseria meningitidis, and Haemophilus influenza were more prevalent in CBM.
  • Risk factors like neurosurgery, sepsis, very low birth weight (VLBW) neonates, and cancer were more frequent in PM, whereas alcohol abuse, otitis/sinusitis, and Roma ethnicity were more common in CBM.
  • Initial treatment success was higher in CBM, but cure after treatment modification was more frequent in PM, leading to similar overall outcomes (14.6% vs. 12.4% mortality).

Conclusions:

  • Bacterial meningitis acquired post-surgery and in the community exhibit distinct etiological profiles and associated risk factors.
  • Despite these differences, the overall patient outcomes for bacterial meningitis are comparable regardless of acquisition source.
  • Tailored therapeutic strategies considering the specific etiology and risk factors may improve management of both PM and CBM.

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